The Mom Stop: State can ease cost of autism

When their son, now 5, was diagnosed, the couple paid out of pocket for his therapy. But the costs add up, especially when hours of therapy are needed.

“Research shows that 10 hours is the minimum to see real results and to get that with a board-certified behavior analyst would cost a minimum of $500 a week,” Deiches said in 2015. “My husband is an instructor at (the University of Alabama) and a high school teacher. We can barely swing the $70 a week for two hours with the therapist that isn’t board-certified.”

Every hour of therapy counts when it comes to a child with autism. The earlier children are diagnosed and receive intervention, the better off they are, said Ryan Jimenez, a licensed behavior analyst in Tuscaloosa, Alabama. Depending on the severity of their cases, some patients require between 10 to 40 hours of therapy a week.

“Early intervention can make all the difference in the world,” Jimenez said, because the sooner an individual receives treatment and therapy, the better their prognosis will be throughout their life.

Problem is, many families in Alabama are forced to run up credit card debt or take out second mortgages just to get the services needed for their autistic children. Insurance and Medicaid in Alabama don’t pay for therapy like Applied Behavior Analysis, a treatment recognized by the U.S. Surgeon General for autism, which is the only scientifically validated treatment.

It forces some families, like the Deiches, to move out of state. The Deiches left Alabama in June 2015 and now live in Apopka, Florida, where their son’s services are 100 percent covered by insurance.

“Services here are amazing,” Deiches said. “Insurances covers everything we could possibly need, and we have access to amazing resources.”

Alabama is one of the five worst states in the nation to live in if you have autism, according to Autismspeaks.org. The other four states are Idaho, North Dakota, Oklahoma and Wyoming. The reason: No state mandate that requires insurance to cover autism services.

In fact, the 45 other states in the U.S. do require insurance companies to cover therapies for autism. Alabama just isn’t one of them. That means the nearly 50,000 families in Alabama who are affected by autism have to pay out of pocket or receive limited ABA therapy services through the public schools.

That could change, however, since the state Legislature is considering HB 284, the Alabama Autism Insurance Reform Bill. Even University of Alabama head football coach Nick Saban and his wife Terry published a letter to legislators recently, urging their support. Still, the issue is being hotly contested in Montgomery as lobbyists fight against the bill as a “tax” through insurance. Advocates of the bill point that in other states, coverage of ABA therapy costs no more than 50 cents per insurance member per month. But it’s yet to be seen if the bill will actually become law.

“I think it’s ridiculous that it’s even being debated,” Deiches said. “Alabama is one of the very last states to require insurance to cover therapy. For once, Alabama should step up and not leave its children behind.”

Indeed, it is time. It is beyond time. Alabama is always last, but it doesn’t have to be.

— Lydia Seabol Avant writes The Mom Stop for The Tuscaloosa News. Reach her at lydia.seabolavant@tuscaloosanews.com.